Inaccurate treatment documentation leads to deficits in billing cycle

May 13, 2015 | Health Insurance Billing

Experts say that one of the challenges medical care facilities face is properly documenting services rendered during treatment. On Healthcare Finance News, Jennifer Zaino interviewed Anthony Oliva, national medical director for healthcare compliance and clinical documentation improvement company J.A. Thomas & Associates. Oliva said that billing and collections often doesn't take the full extent of treatment into account due to poor documentation. 

"It's amazing how many times I've seen records where the discharge diagnosis, for example, says only 'cellulitis,' but the patient spent three days in the ICU being treated for sepsis," said Oliva. "The reimbursement isn't even going to be close to what the cost was."

Implementing new strategies for more comprehensive billing can optimize the revenue cycle for hospitals, private practices and other care facilities. With enhance documentation, administrators can communicate with insurance providers and patients about the full bill of care received. Lapses in recording treatments can lead to facility costs that go unaccounted for in budgets, slowly eating away at hospital or practice resources. Zaino's piece suggests that the more detailed medical records are when first transcribed, the more accurately bills will reflect services rendered. 

Oliva's suggestion is a reminder that hospital billing and collections need to be engineered from the patient experience through the receipt of payment. When costly treatments go overlooked, time and money are stretched thin. Mistakes in billing also create more work for hospital accounts receivables administrators, who are charged with collecting on outstanding debts. Those positions can also be unburdened when facilities outsource receivables management. Contact Professional Medical Services today to learn more about how our solutions can help reduce backlog at your facility, allowing administrators to focus their attention on high-priority claims.